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On your bike: Cycling to work linked with large health benefits

by UNTV News   |   Posted on Friday, April 21st, 2017


FILE PHOTO: Commuters cycle through Oxford Circus in London, Britain, August 5, 2015. REUTERS/Darren Staples/File Photo

People who cycle to work have a substantially lower risk of developing cancer or heart disease or dying prematurely, and governments should do all they can to encourage more active commuting, scientists said on Thursday.

In a study published in the BMJ British medical journal, the researchers found that cycling to work was linked to the most significant health benefits – including a 45 percent lower risk of developing cancer and a 46 percent lower risk of heart disease compared to non-active commuters.

Walking to work was linked to a 27 percent lower risk of developing heart disease and a 36 percent lower risk of dying from it, though it also appeared to have no effect on cancer risk or overall premature death risk, the study showed.

The research involved 264,377 people with an average age of 53 whose data forms part of the UK Biobank – a database of biological information from half a million British adults.

Since the study was observational, no firm conclusions can be drawn about cause and effect, the researchers said. Its findings could also be affected by some confounding factors, they added, including that the mode and distance of commuting was self-reported, rather than objectively measured.

However, “the findings, if causal, suggest population health may be improved by policies that increase active commuting, particularly cycling”, they said.

These would include creating more cycle lanes, introducing more bike buying or hiring schemes, and providing better access for cyclists on public transport.

Lars Bo Andersen, a professor at the Western Norwegian University of Applied Sciences, who was not directly involved in the research but wrote a commentary on it in the BMJ, said its findings “are a clear call for political action on active commuting”, saying this had the potential to significantly improve public health by reducing rates of chronic disease.

“A shift from cars to more active modes of travel will also decrease traffic in congested city centers and help reduce air pollution, with further benefits for health,” he said.

(Reporting by Kate Kelland, editing by Gareth Jones)

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Air quality linked to cardiac ‘events,’ heart disease patients unaware

by UNTV News   |   Posted on Wednesday, April 18th, 2018

FILE PHOTO: A cyclist wears a mask as he cycles near Buckingham Palace in London April 2, 2014. REUTERS/Luke MacGregor

Poor air quality with high levels of tiny pollution particles known as PM 2.5 are tied to a spike in emergency department visits for heart- and lung-related illnesses and stroke, a California study suggests, but a nationwide U.S. survey finds that few heart patients are aware of air quality risks.

Based on analysis of areas affected by the intense 2015 California wildfire season, researchers found that within a day of residents being exposed to dense smoke, emergency room visits for heart attacks and other cardiac events and symptoms rose by 15 percent overall, and 42 percent among people over age 65.

Stroke and other cerebrovascular emergencies rose 17 percent overall, and 22 percent for older adults, the study team reports in the Journal of the American Heart Association.

“Unlike places that have chronic exposure to poor air quality where we can educate people about the health risks, wildfires happen at unexpected times,” said senior study author Ana Rappold of the U.S. Environmental Protection Agency’s National Health and Environmental Effects Research Lab in Durham, North Carolina.

“Wildfires have become a leading cause of short-term exposure to polluted air,” she said in a telephone interview. “It’s important to talk to people about how exposure to wildfire can impact their health.”

Large-scale wildfires are projected to increase through the end of the century in many areas, particularly in California, Rappold and her colleagues note in their report. Wildfire smoke contains several pollutants, including carbon monoxide, nitrogen dioxide and ash particles that have been associated with lung and heart problems.

It also contains tiny particles, smaller than 2.5 micrometers, that are produced by burning, such as in wildfires, indoor cooking fires and motor vehicle exhaust.

These particles are small enough to enter the bloodstream from the lungs and are linked to inflammation, heart rhythm disturbances and clotting issues, the authors write.

Rappold and colleagues analyzed emergency room visits between May 1 and September 30, 2015 in eight northern and central California basins where fires covered more than 800,000 acres of land.

Based on data from the National Oceanic and Atmospheric Administration, the research team followed smoke plumes and particulate matter concentrations as they moved across the state. They also looked at emergency room data for diagnoses such as heart attack, angina, cardiac dysrhythmia, pulmonary embolism, stroke, asthma, COPD and pneumonia.

The researchers found 361,000 cardiovascular, 15,500 cerebrovascular and 230,000 respiratory diagnoses. Emergency room visits for heart issues were associated with wildfire smoke density for all adults and were more pronounced for those over age 65. Brain and lung issues were also more severe among older adults, especially on medium- and dense-smoke days.

“We have an aging population in this country with increasing obesity, diabetes and associated heart and lung diseases, and we have an increasing number of acres that burn every year,” said one of the study’s coauthors, Dr. Wayne Cascio, who directs the EPA National Health and Environmental Effects Research Lab.

“We also have an increasing number of people encroaching on acres that have a high likelihood of burning,” Cascio said in a telephone interview. “That’s the perfect storm of increasing the number of people who are at risk for wildfire exposure.”

In future studies, the EPA team plans to look at how long wildfire smoke and particulate matter lingers in the air and causes health problems, as well as how these air pollution exposures affect healthcare expenses through programs such as Medicare.

They’ve also launched Smoke Sense (bit.ly/2gFdHTV), a mobile app that encourages people to submit information about wildfire exposures and their health and productivity.

“I tell my patients that if they have heart or lung disease, they need to be mindful about poor air quality and smoke from wildfires,” Cascio said. “Avoid them to the extent that you can and look at EPA resources or others to plan what else you should do.”

In a separate study by a team at the Centers for Disease Control and Prevention in Atlanta, researchers found that people with lung disease are more likely than those with heart diseases to be aware of the risks they face during poor air quality alerts.

The research team analyzed surveys of more than 12,000 U.S. adults between 2014 and 2016. About half of participants were aware of air quality alerts, 27 percent said they avoided busy roads to reduce their exposure and 3 percent said they had talked with a health professional about ways to avoid exposure to air pollution. Compared to the other survey participants, awareness of air quality alerts was 11 percent more common among people with asthma and avoidance of busy roads was 13 percent more common. People with asthma were also five times more likely to have spoken with a doctor about avoiding pollution exposure.

“Targeted public health messages about air quality might raise awareness about alerts and motivate changes in behavior among those at risk during periods of unhealthy air quality,” said lead study author Maria Mirabelli of the CDC’s Asthma and Community Health Branch.

“Be aware of air quality alerts and discuss with a health professional the strategies to reduce air pollution exposure,” Mirabelli advised in an email. “Avoid busy roads to reduce exposure when walking, biking or exercising outdoors.”

SOURCES: bit.ly/2HGf8hz Journal of the American Heart Association; online April 11, 2018; and bit.ly/2HpUapo American Journal of Preventive Medicine, online March 15, 2018.

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Many breast cancer survivors may die of heart disease, doctors warn

by UNTV News   |   Posted on Thursday, February 8th, 2018

FILE PHOTO: A breast cancer patient listens to her doctor after a radiological exam in a file photo. REUTERS/Yannis Behrakis

(Reuters Health) – The same advances in breast cancer treatment that have dramatically improved survival in recent years have also left a growing number of women vulnerable to potentially fatal cardiovascular problems, the American Heart Association warns.

Chemotherapy can weaken the heart muscle, some newer targeted medicines can increase the risk of heart failure, and radiation can cause heart rhythm disorders and structural damage in the arteries and heart valves, the AHA emphasizes in its scientific statement on the link between breast cancer and heart disease.

Cardiovascular disease is the number one cause of death in women, and this risk increases with age, noted Dr. Laxmi Mehta, lead author of the statement and section director of preventive cardiology and women’s cardiovascular health at the Ohio State University Medical center in Columbus.

“So as breast cancer survivors are living longer, their risks of cardiovascular disease increase,” Mehta said by email.

Breast cancer survivors, especially women over age 65, are more likely to die from cardiovascular disease than tumors, the AHA statement stresses.

This doesn’t mean women should skip lifesaving cancer therapies, but it does mean they should be aware of the cardiac side effects and be monitored for cardiovascular disease during treatment and afterwards, Mehta added.

“Any patient who is going to undergo breast cancer treatment, whether they have heart disease at the beginning or not, should be aware of the potential effects on their heart,” Mehta advised.

Several cancer treatments have long been linked to an increased risk of heart problems in the future.

For example, anthracyclines, such as doxorubicin, are a type of chemotherapy that has been used since the 1970s and can cause irreversible damage to the left ventricle, the heart’s main pumping chamber.

And taxanes, such as paclitaxel, have been linked to irregular heart rates and rhythm disorders.

Trastuzumab and pertuzumab, targeted therapies for an aggressive type of malignancy known as HER-2 positive breast cancer, can also damage the left ventricle but this damage may be reversible after treatment stops. Women who develop heart failure while taking these drugs may be able to alter treatment to help prevent worsening or permanent cardiac damage.

Another chemotherapy – doxorubicin – can damage heart cells, but the risk of heart failure may be reduced when the medicine is administered slowly, rather than all at once. Women taking this medicine may also reduce their risk of heart failure by pairing it with another drug, dexrazoxane.

Radiation can damage arteries and cause blockages, but newer techniques can deliver lower and more targeted doses of radiation that are less toxic to the heart than standard regimens a generation ago.

Heart disease and breast cancer share many of the same risk factors, including obesity, inactivity, smoking, and poor eating habits, according to the AHA statement published in Circulation. Lifestyle changes designed to avoid these risk factors may help women minimize their risk of cancer and heart problems.

“Women have a higher risk for heart disease if they go untreated for existing cardiovascular risk factors or develop risk factors such as obesity or low fitness during breast cancer treatment,” said Dr. Susan Gilchrist, a cardiology professor at the University of Texas MD Anderson Cancer Center in Houston.

Even when women don’t have any risk factors for heart disease when they’re diagnosed with breast cancer, they should still adopt a heart-healthy lifestyle to lower the chances of developing heart problems associated with cancer treatments, the AHA recommends.

“The key message is to be proactive and focus on prevention,” Gilchrist, who wasn’t involved in the AHA statement, said by email. “Stay active during treatment, avoid smoking and weight gain, get to goal with blood pressure and cholesterol, and do appropriate cardiovascular screening as determined by your oncologist.”

SOURCE: bit.ly/2C3JVjM Circulation, online February 1, 2018.

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Married heart patients more likely than singles to survive

by UNTV News   |   Posted on Friday, January 5th, 2018

FILE PHOTO: A couple embrace as they watch the sunset from a promenade along the Arabian Sea in Mumbai, in this February 14, 2012 file photo. REUTERS/Vivek Prakash

(Reuters Health) – People with heart disease have better long-term survival odds when they are married, a recent U.S. study suggests.

Compared to divorced, widowed and never-married peers, who were up to 71 percent more likely to die during a follow-up of several years, married patients also had fewer heart risk factors like high blood pressure and were more likely to be on heart medications.

“We measured biomarkers including cholesterol, high blood pressure and presence of diabetes. True, unmarried patients are dying more because they have these conditions. But just the marital status in and of itself is an independent risk factor,” senior study author Dr. Arshed Quyyumi of Emory University School of Medicine in Atlanta told Reuters in a phone interview.

Quyyumi and his team looked at the relationship between marital status and incidence of cardiovascular death, heart attack and death from any cause in 6,051 men and women who had their clogged heart arteries cleared at Emory Healthcare hospitals between 2003 and 2015. Follow-up ranged from 1.7 to 6.7 years, averaging about three and a half years.

Overall, the unmarried patients were 1.45 times as likely as the married patients to experience a cardiovascular event leading to death, 1.52 times as likely to have a heart attack and 1.24 times as likely to die from any cause during the follow-up period, the researchers report in the Journal of the American Heart Association.

Widows fared the worst, with a 71 percent higher likelihood of heart attack or cardiovascular death compared to married patients. Divorced, separated and never-married patients had about 40 percent higher odds for those events.

Past research has found that being married is associated with better health and survival overall, the study team notes, although the mechanisms involved need further study.

“It’s a culmination of factors,” said Dr. Rahul Potluri of Aston Medical School in Birmingham, UK, who wasn’t involved in the study. “Benefits of marriage include the impetus to look after one’s health. There’s an increased likelihood to seek and obtain healthcare for the detection of chronic conditions such as diabetes and hypertension. Keeping away from smoking due to a ‘nagging partner’ can also play a role,” he said.

People with a spouse tend to have a greater purpose in life and are more likely to take responsibility for their health through diet, exercise and medication adherence, Quyyumi noted. But when a significant other is no longer in the picture, compliance starts to slip.

Other possible explanations for the apparent protective effects of marriage include a lack of social support combined with acute stresses that come with divorce, extended bereavement followed by the loss of a loved one and the reduced interaction that comes with living alone, he said.

A lack of social support has been thought to worsen outcomes in cardiac patients after divorce, Quyyumi said, suggesting that the emotional and financial stress of divorce may play a role in adverse outcomes.

“But it’s important to remember that divorce comes in different shades,” he added. “It’s a mixed bag. For some it is stressful, but for many it can be a relief. Interestingly, previous studies have demonstrated that remarriage may attenuate the increased risk of a cardiac event often observed after divorce.”

In the widowed group, it may have to do with psychological and behavioral events that accompany life’s course.

“Some people give up after the loss of a spouse. Bereavement shouldn’t be taken lightly and people who find themselves sick and alone must be aware that they are at a greater risk of a secondary cardiovascular occurrence, or worse, death,” Quyyumi said.

“We obviously cannot prescribe marriage to patients,” Potluri said. “But we can emphasize the role of relationships and friendships in managing coronary artery disease.”

“Try to regain a sense of purpose,” Quyyumi said. “Whether that’s finding another partner to compensate for the social support one has lost, becoming more involved in your children’s family or finding a church group. These things all help a patient to once again become more interested in saving their own life.”

SOURCE: bit.ly/2CF8k3s Journal of the American Heart Association, online December 20, 2017.

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